This option allows you to streamline its printing management models that can fill officers and deliver on its Delegation Provincial or in the central services. We hope that it will be useful.
NEW: Application forms may be filled from the screen , para a continuación Imprimirlos. Para poder editarlos correctamente, deberá disponer de la última versión del software Adobe Acrobat Reader. Si no lo tiene instalado, puede download Adobe Acrobat Reader ® from the Adobe ® in spain.
Highlights
- Download Parts of Low (PDF) .
- Application Services: of recipes (PDF) (Provisionally may request the new recipes telephone by a resolution of the secretary of state for Territorial policy and Public Role on the occasion of the COVID-19).
- Request for new parties Low (PDF).
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Membership
- Request for the affiliation and change data A-1 Holders (PDF) .
- Application Admission of Widowers/widows and orphans/Orphan A-2 (PDF) .
- Request for the Voluntary Affiliation (PDF) .
- Application High/Re-Entry payee/Beneficiaries A-3 (PDF) .
- Application Low beneficiary/a A-5 (PDF) .
- Application Low of Mandate Holders A-4 (PDF) .
- Application Medical switching (PDF) .
- Application Individual Membership card (PDF).
Health benefits
- Request for high/update of data for the provision of Healthcare outside national territory by destination or residence (PDF).
- Application Mixed Commission (PDF) .
- Application Health compensation outside national territory (PDF).
- Application European Health Card (PDF) .
- Request for authorization of Special medical treatments abroad (PDF)
Pharmaceutical benefits
- Application Reimbursement of expenses of pharmacy (PDF) .
- Application Recipes visa (PDF)
- Model of medical report to the medicines and health products requiring Recipe visa (PDF)
- Model Medical Report type instrument of indication for enteral treatments with nutrition home (PDF)
- Model Medical Report supporting type of dietoterápicos treatments in congenital metabolic disorders (PDF)
- Model for visa Medical Report provided for medicines técnicas de reproducción asistida de ciclos autorizados por la Entidad Médica (PDF)
- Modelo de Certificado de la Entidad Médica sobre autorización con cargo a la misma de la medically assisted reproduction technical (PDF)
- Application of model Authorization of dispensing medicine hospital (PDF).
- Proof of model Withdrawal of hospital treatment drugs without coupon precinct (PDF).
- Model Alcohol tabáquica Medical report
Other benefits
- Request for assistance Social assistance fund (F.A.S.) (PDF) .
- Application for Major Disability (PDF) .
- Application for Disabled children (PDF) .
- Request for withdrawal by Permanent Disability (PDF) .
- Request allowance Temporary disability (PDF) and Model 145 (PDF).
- Grant application Retirement (PDF) .
- Request for compensation by Permanent Injuries not Disabling (PDF) .
- Application for Birth or adoption of the child (PDF) .
- Request for financial aid in cases of Childbirth, adoption and placement multiple (PDF) .
- Request for expenses Funeral expenses (PDF) .
- Request for assistance of the programme of assistance for persons with Disabilities (PDF)
- Request for assistance of the programme of assistance for persons with Drug-dependent persons (PDF)
- Request for assistance of the programme of assistance for persons More (PDF)
- Request for assistance Psychiatric hospitalization (PDF) .
- Application for assistance by treatment Physiotherapy and speech therapy (PDF) .
- Request for assistance Supplementary Benefits (PDF) .
- Request for help maternal financial input at certain products ortoprotésicos (PDF) .
 Special fund